Don’t stress over incontinence

Tightening the pelvic floor muscles through Kegel exercises can control Stress Urinary Incontinence, writes Dr Rubina Shanawaz Z

If there is one topic on women’s health that is grossly ill-understood by 90% of the population, it undoubtedly is Stress Urinary Incontinence (SUI). Is it because it is not life-threatening or that it usually presents itself in older people who have more debilitating health issues at stake?

What is SUI?

SUI is a type of urinary leak that is triggered by stress. The ‘stress’ that is referred to here is any chronic exertion or pressure on the pelvic floor. The pelvic floor is the main muscle holding up the uterus, urinary bladder and rectum in females. This pressure could be:

Due to chronic conditions like chronic cough, constipation and obesity.

Or in the form of weakness and injury to the pelvic floor due to traumatic childbirth, age-related weakness or genetic laxity of the pelvic floor muscles.

How will I recognise it?

If you find an uncontrolled spurt of urine during physical workouts like playing tennis or during an aerobics class; while having sex; when coughing or lifting something off the floor; or in severe cases, by just changing your posture? Then chances are that you have SUI.

What can I do to prevent this from happening?

Exercise regularly and maintain a healthy diet to keep your weight in check.

Treat the underlying conditions (like incessant cough and constipation) that cause pressure on the pelvic floor.

Regularly do pelvic floor (Kegel’s) exercises. They help in the prevention and treatment of mild SUI.

When can I do Kegel’s exercises?

The great thing about Kegel exercises is that they can be done anywhere and anytime… Because the only person who will know you are doing it is you! It doesn’t require you to set aside time from your busy schedule or isolate yourself. All you need to know is how to isolate the pelvic floor. Identify two times of the day when your routine is fixed and incorporate these exercises into those times. For example, while reading your book before bed, or cutting vegetables for lunch, or watching TV in the evening or even while travelling in a car…whenever and wherever it is convenient for you.

What does Kegel entail?

Imagine you need to stop peeing midstream. The muscles you use then are the muscles you need to contract for pelvic floor exercises.

Contract the muscle and slowly start counting. Initially, hold for 5 counts and gradually, over the weeks, increase to 10 counts

Relax for 3-5 seconds.

Do 10-20 such repetitions, twice a day.

You will have to practice for 3 months at least to determine if this helps you or not.

If it helps, continue lifelong.

What precautions do I need to take?

Do these exercises on an empty bladder.

Don’t hold your breath while exercising.

Don’t overdo the repetitions or recommended frequency as overexertion with the wrong technique will turn out to be counterproductive.

At what age should I start doing these exercises?

The pelvic floor laxity usually starts with the first pregnancy. This would be an ideal time to start the exercise. If this issue presents earlier than that, then ensure that you start these exercises immediately. Once you start, make sure to incorporate it into your daily routine.

(The author is a senior consultant in obstetrics & uro gynaecology.)